Pharmaceutical care is evolving as new technologies adapt to meet the demands of more tech-savvy customers as well as new services like Pharmacy First. By Saša Janković

From recording scripts and services to exchanging information with GPs and automating aspects of the dispensing and prescription process, technological solutions are revolutionising the way some pharmacies operate and helping them to navigate a complex and changing market.

Pharmacy robot suppliers report that demand for automation has been growing exponentially over the past 24 months to meet increased customer needs as a result of pharmacy closures.

“The dissolution of 950-plus stores from the Lloyds group together with substantial numbers of contracts becoming available from Boots, Well and Day Lewis has provided a significant shift in pharmacy contracts to the independent sector,” says MediTech CEO Timon Dejonghe. He sees a real-world decrease in the fiscal return for dispensing and a move towards remuneration for provision of clinical services as well as the increase in the minimum wage necessitating an acute focus on dispensing efficiency process.

“Pharmacy owners are finding salvation through using automation to reduce their reliance on more staff and to release skilled pharmacists’ time for providing profitable clinical services,” Dejonghe says. MediTech’s latest solutions to this challenge include the stand-alone MT.Matic click and collect module and sales kiosks that allow customers to buy and collect healthcare products such as test kits and sexual health products out of hours, directly from the kiosk using a touch screen.

Kathryn Hughes, senior national sales manager at Omnicell UK & Ireland, says Covid was “a real awakening for the sector as it heightened the needs and expectations of the ‘savvy shopper’ to have everything at the click of a button, which did not exclude the pharmacy sector and really catalysed the growth of automation”. Omnicell’s portfolio covers everything from automation solutions such as Pharmaself24 24/7 prescription collection kiosks to medication dosage systems (MDS) and pack-picking dispensing robots – all of which Hughes says have the same purpose and goal: to drive efficiency and accuracy and free up staff time, “which can be spent instead on more patient-facing care”.

BD Rowa has also added to its portfolio, which now includes the Synmed pharmacy automation system for preparing single and multi-dose blister cards. This complements the BD Rowa Dose, with its pouch packaging capability. “Each blister pack includes specific patient data and an optional photo, with the potential to improve medication adherence and reduce dispensing errors,” says Harry Tomlinson, dispensing retail sales leader, Northern Region. “This enables personalised and safer care, empowering pharmacists to become even more impactful in improving patient outcomes and delivering value for the local community.”

Technology and software that automates the original pack dispensing process are some of the market’s most recent innovations. “For groups of pharmacies with the same legal entity, this includes scalable and affordable hub and spoke technology, which can work for a group with as little as three branches,” says Louise Laban, sales and marketing director at Centred Solutions, which specialises in technology that automates the original pack dispensing process for repeat prescriptions.

“We need to move away from the perception that hub and spoke is only an option for the largest pharmacy groups – that’s simply no longer the case,” she says. “Technology is now available which is affordable and fully scalable so pharmacies have the option to start small and grow the solution over time.”

Latest PMR developments

Another significant stride in the realm of pharmacy automation is the evolution of Patient Medication Record (PMR) systems towards enhancing communication channels between pharmacies and patients.

“This transformation not only aims to offer patients greater visibility into their healthcare journey but also serves to alleviate the workload burden on pharmacies,” says Santosh Sahu, founder and CEO of Charac, a digital platform that enables pharmacies to provide repeat prescriptions and patient consultations via phone, video, desktop or mobile.

“One notable advancement is the incorporation of inbound consultation referrals into PMRs, exemplified by the NHS Community Pharmacist Consultation Service,” he says, “as well as the emergence of delivery management systems which offer patients real-time updates on the status of medication deliveries and facilitate the scheduling of repeat prescriptions, particularly benefiting individuals with mobility constraints or chronic health conditions.”

Recent years have also seen efforts to integrate PMRs with electronic health records, patient apps and innovative machine learning tools. In addition, pharmacy robot suppliers are making sure their kits integrate with PMR systems. For instance, Meditech integrates with Analyst (PSL), Proscript (EMIS), Pharmacy Manager (Cegedim), and RX-Web, and Laban says Centred Solutions’ technology that automates the original pack dispensing process for repeat prescriptions is able to interface “with most PMR providers”. Meanwhile, BD Rowa’s Pickup Cloud enables pharmacies to store pickup items and orders within its Vmax system, but it can be used as standalone software as well.

Steve Russell, chief commercial officer at Positive Solutions, says his company’s Script Queue Filters, Enhanced Clinical Review and Assisted Dispensing innovations can free up, for a typical pharmacy, a third of their time every week. “We’ve pioneered mobile scanning technology in pharmacy for years now,” adds Russell, “and most of our customers use either our Quickpick batch picking app or Handout, our shelf management and retrieval app, or, increasingly, both. Handout now also features customer collection codes and automated, tailored patient messaging – significantly cutting down on calls into the pharmacy and massively improving the patient experience. This spring by introducing BYOD (bring your own device), we are allowing our customers to use their own, cost effective Android devices for all our scanning apps.

Dejonghe says some of the most exciting developments he has seen are from Pharmacy X and Titan, both of which integrate with MediTech automation. “Paul and Ben Mayberry from Pharmacy X have brought real stock control into the PMR and have spent a lot of time minimising the number of clicks needed to navigate the stylish user interface and have fully integrated with all of the principal wholesale and cascade platforms to make stock ordering and processing simplicity itself.

“Titan has always been a progressive thinker when it comes to innovation and workflow. We have seen its batch picking workflow up close and this is a real innovation for bulk picking. But one of the best features being released by multiple PMR vendors (Pharmacy X, Titan and PSL currently) is the ability to use a combination of robotic picking and scanning through the PMR to create a self-validating prescription bagging. This eliminates about 60-70 per cent of pharmacist accuracy checking and releases time back to patient care and service provision for the pharmacy’s most expensive resource.”

Tariq Muhammad, CEO of Invatech Health and creator of the Titan system and the Titan.X AI system for pharmacy, says his focus has now shifted onto a new product called Titanverse. Soft-launched in September 2023 and now being trialled in a number of pharmacy stores, this is a central web-based portal that helps businesses manage their operations as well as the delivery of clinical services.

“Amongst its features, Titanverse consolidates all the patients across every pharmacy within a company and presents them on a central portal,” explains Muhammad. “From here, businesses can create a new service, send campaigns, allow bookings and even take payments. Each successful booking is then presented on a board, ready for the pharmacist to simply carry out the service. As a result, Titanverse enables pharmacists to work together in delivering a mass volume of services – which could be multiple pharmacists working on behalf of a single busy pharmacy, or a single pharmacist supporting multiple pharmacies, and all of this is fully integrated into the Titan dispensing workflow.”

Delivering Pharmacy First

As pharmtech companies develop their products at pace, they still need to be able to plug into evolving services to be able to make a real difference to the pharmacy contractors they are aiming to serve – with Pharmacy First the latest benchmark for this.

“Without the right digital tools to support better communication to and about patients, pharmacies may struggle to deliver Pharmacy First, which could cause patients to feel like they are getting bounced around the system,” warns Dr Margaret Senbanjo, clinical lead at Accurx.

“Colleagues in GP surgeries have seen the benefits of communication tools to transform entire pathways of care for some years now, and we will need to see adoption of these same tools in pharmacies and work collectively to safely deliver Pharmacy First care.”

Positive Solutions is one of the PMR providers chosen by the NHS to pioneer Pharmacy First – the others being PharmOutcomes, Sonar, Cegedim and Positive Solutions, with Titanverse currently going through NHS approval.

Russell says: “There is much more to do. In the furore to get Pharmacy First live, the NHS was forced to make a few hard choices over prioritisation – access to GP records has been pushed back slightly, along with services like smoking cessation and the discharge medicines service. Even more so, the booking and referral standard (BaRS), which will effectively serve as a standard protocol for transferring information digitally between different areas of the NHS, can’t come soon enough. Then there is the claiming integration into NHSBSA, which will close the loop and provide an automated end-to-end service solution.”

However, Russell says the work taking place to integrate with GP systems, both to access the patient record when delivering a consultation and updating the patient record, is “truly groundbreaking”.

He adds: “I predict this will have hugely positive implications for contractors in allowing them to transition from effectively processing orders to truly fulfilling their potential as valued clinical practices right where and when the patients need them.”

Case study: Callendar Pharmacy

Callendar Pharmacy in Falkirk, Scotland, is a busy pharmacy doing 12-13,000 items a month. It serves a large number of high-rise flats for people over the age of 50, runs a sizeable delivery service and has around 450 dosette box patients.

Owner Richard Grahame says technology has played a major role in helping him and his team to fully engage with the Pharmacy First initiative in Scotland, which was introduced in 2020, the same year he installed Omnicell’s Pharmaself24 Collection Kiosk.

“I own six pharmacies in total and we are about to purchase our fourth Pharmaself24, such has been its success,” he says. “The decision to invest in this technology gave us new potential to grow our share of prescriptions without the costs associated with expanding our already over-subscribed home delivery service. We are an extremely busy pharmacy, so not only did this investment help free up staff time to spend on more valuable, customer-facing tasks, I also saw it as a means to future-proof our business. With fierce competition and pharmacy closures on the rise, not only did collection kiosks fill a clear gap in the market by providing patients with convenient access to their medicines, it also helped us provide a clear point of differentiation in the local area, and it’s been a huge hit with patients too.”

Richard says he would urge community pharmacists to view technology investment as a means to growth and to remaining financially viable. “While it can seem like a huge financial outgoing at the outset, I firmly believe its long-term benefits make it worthwhile”, he says.

Case study: Murray Pharmacy

Murray Pharmacy in East Kilbride, Scotland, serves a population of 75,000 residents. With the recent extension of Core Services through Pharmacy First, owners Sanjay and Anish Majhu had started to get busier, but realised a large amount of time was being taken up with managing stock and labelling.

“I decided a dispensing robot would free up time by helping manage stock, providing us with reports for monitoring stock levels and always selecting the product nearest to expiry,” says Sanjay.

“After seeking advice, we chose a BD Rowa Vmax and ProLog. It has reduced our workload by 30 per cent, improved service speed, and spared us from hiring additional skilled staff. It also created an £8.5k saving on stock holding in the first two months, and enabled us to redistribute low turnaround and short-dated stock to other Murray Pharmacies.”

Another unexpected bonus is that having less stock has enabled the pharmacy to reduce the number of shelves in the retail space, creating additional room for a consulting area and space for customers to move around.

“Our business is now more efficient, and reducing time pressures means our team enjoys a happier working environment,” says Sanjay.